Emerging treatments

Balloon Eustachian tuboplasty

In balloon Eustachian tuboplasty (BET), a balloon catheter is inserted into the Eustachian tube under endoscopic visualisation and subsequently inflated. The treatment principle is that balloon dilatation of the Eustachian tube may restore its normal function, although the exact mechanism is not well-established.[97][98][99][100] This procedure was initially described in adults and has recently been investigated for treatment in children. In adults, BET has been associated with OME resolution in 50% to 66% of patients.[101][102] In children, BET has been found to be associated with an improvement in air-bone gap of 18 dB, compared to an improvement of 8 dB in the tympanostomy tube group.[103] Furthermore, BET performed in conjunction with tympanostomy tube placement may extend the hearing benefit associated with the tympanostomy tubes.[104] Specifically, similar hearing thresholds were found between the BET and tympanostomy tube groups at 6 months after-surgery. At 12 and 18 months, the air-bone gaps observed in the BET group were less than those observed in the tympanostomy tube group.[104] In adults, guidelines indicate that BET may be considered in dilatory Eustachian tube dysfunction where medical therapy has failed.[97] There are currently no guidelines on the use of BET for managing OME in adults or children. The evidence is still evolving and there is no consensus.

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